基于潜在剖面分析的脑卒中患者报告临床结局异质性研究

Exploring heterogeneity of stroke-patients with latent class analysis based on patient reported outcomes

目的 根据患者报告临床结局探索脑卒中患者的异质性亚型。方法 选取山西省9家不同等级的医院或社区卫生机构脑卒中患者为研究对象,采用一般资料调查表和脑卒中临床结局评价量表(Stroke-PROM)对其进行调查。以Stroke-PROM各维度最终得分为模型外显变量,利用潜在剖面分析构建分类模型,采用方差分析和相关分析对可能影响分型的各因素进行评估。结果 低生理低社会型(9%)、高生理中社会型(40%)、中生理中社会型(26%)和中生理高社会型(25%)是潜在剖面分析结果中平行可比的4个亚型。潜在类别在4个领域上的得分均具有统计性差异(P<0.05),与患者的年龄、费用支付形式和运动频率之间存在相关性(P<0.05)。结论 脑卒中患者存在明显的分型特征,应重点关注处于高龄、自费状态和缺乏运动的脑卒中患者,提供有针对性的护理措施改善其生命质量。

Objective To categorize and describe stroke-patients based on factors related to patient reported outcomes.Methods A questionnaire survey was conducted among stroke-patients in nine hospitals and communities in Shanxi Province.The general information questionnaire and stroke-patient reported outcome manual(Stroke-PROM)were completed.Latent profile analysis was used to analyze the scores of Stroke-PROM,and the explicit variables of the model were the final scores of each dimension.ANOVA and correlation analysis were used to measure the correlation between the factors and subtypes.Results Four unique stroke-patient profiles emerged,including a low physiological and low social group(9%),a high physiological and middle social group(40%),a middle physiological and middle social group(26%),and a middle physiological and high social group(25%).There were significant differences in scores of four areas among patients with different subtypes(P<0.05).Moreover,there was a correlation between age,payment,exercise and subtypes(P<0.05).Conclusion There are obvious grouping characteristics for stroke patients.It is necessary to focus on stroke patients who are advanced in age,have a self-funded status and lack exercise,and provide targeted nursing measures to improve their quality of life.